Insurance Membership Request Form

Please complete all the details below for your insurance membership request and allow up to seven business days for your request to be processed.

Please note, all multi visit swim passes expire 12 months from the date of purchase. Customers purchasing a swimming multi visit pass for the first time will be required to purchase an access card ($3.70).


Please enter your contact information

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Member Details

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Select your membership option



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Invoicing Details

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Membership start date(*)

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Supporting Documentation

If you have any supporting documentation, please upload.
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Additional comments

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